T Nation

Getting Serious - 36yo w/ Journey


#1

Age 36
Ht - 5'9"
Wt - 195-200
Bodyhair - "normal" although much less than other adult men in my family
Meds - I have taken Adderall since I was 23, and buproprion (explained below)
TT - 300 ng/dL (range 300-1000) in 2010
Glucose (boderline, I can't find the #)
BP - 135/80
LDL - 90
HDL - 130

I had TT sample drawn yesterday, get results Friday. I am looking for advice on what questions I need to ask on Friday.

I will try to make this a quick Hx:
From 1997 to 2007, I was a competitive PLer in the 220's (never won my weight class). July 07, I broke a bone my hand in a squat rack, and decided I was getting fat, so I went on a Christian Thibdeau routine, and dropped my weight from 232 to 197 over the course of 6mo. I felt great.

In early 2008, I had an "event" at the gym after my workout: dizzyness, weakness, tunnel vision, generalized pain, numbness in my fingers, loss of bowel control, and eventual loss of consciousness. Carted to ER, then 2 days in the hospital for a full workup: echo, head CT scan, Cardiac MRI, bloodwork, etc. The explanation was "hyperventilation."

It happened again 6 months later, then started happening on a regular basis. In Fall 2008, the 2nd cardiologist I saw gave me a "tilt test" which repeated my symptoms exactly when he gave me nitroglycerin. He diagnosed Neuro-Cardiogenic Syncope (NCS) that causes low blood pressure and low cardiac output immediately following exercise, as blood pools in my veins too quickly after exercise (overactive "cooldown"). He prescribed an SSRI to treat.

6-8 weeks later, I started having some trouble with my right foot, which became a limp, and then became cane-dependent to get around. I also developed a tremor in my right hand, and periodic body spasms and "tick." Also developed ED and became very depressed (depression is a strongly family heredity trait in my entire family.) By Christmas, many thought I was celebrating my last holidays.

Fortunately, the motor function symptoms cleared up about 2-3 months after stopping the SSRI (early 2009). However, the ED and depression persisted into 2010. I went through several months of behavioral therapy, and ended up on Welbutrin after trying several SSRI's. I now control my NCS by eating a high-salt diet, drinking lots of water and sports drinks, and avoiding diuretics like caffeine before exercise or outdoor activities.

Also in 2010, I switched to a less stressful job to better manage my health, and committed to a regimen of HIIT and strength exercise (mostly olympic variations.) I also set up a "warrior diet" style food routine. I have managed to get my weight under 200 again, and I am in the best shape of my life, CV-wise. But I still have an abdominal fat roll, love handles and man boobs, even though I can see veins in my delts, quads, hams and calves.

My trainer, who has an MS in Kinesiology and is a speaker at exercise conferences, He told me "I have never seen anyone work this hard, this long, with your diet, and seen worse results. You need to see a doctor."

I wished I had come to this T-Nation forum last year. In 2010 as part of a routine follow-up and to evaluate my ED, my TT test came back with the lowest possible "in-range" value. It didn't even occur to me to challenge that result at the time, thinking it would be age adjusted. After reading this forum, I went to the wikipedia page - I have been treated for or currently manifest each of the first 15 symptoms of hypogonadism, as well as several others after the first 15.

I also have to acknowledge that while I have seen my body change in weight and shape over the last 20 years of training, my bench and deadlift have never gone above what it was when I was 19. I also have to acknowledge that while I am not the most laid back person on the planet, I have drastically reduced my stress level and my outside commitments to improve my health, and I am still not better.

I will post again Friday after I get all my results. Comments welcome in the interim.


#2

I know more about thyroid than test problems, but if you were looking to get some questions for Friday, I would first ask get a lab done with FSH, LH, Free T and Estradiol(E2). You should get your adrenals (8am cortisol draw) and the base thyroid tests done too (TSH, fT3, fT4).

I do not think that simple total T will be enough to let the posters here help.


#3

the site ate my earlier post !#@$

1) read the finding an HRT Doc thread
2) read the blood test sticky thread
3) read the other sticky threads as they have some great info
4) call the doc and get your results in your hands before the visit if you can.
5) post the results here and discuss them with us
6) go in armed in order to partner with your doctor on your treatment

good luck.